FREE Physician Assistant Pulmonary System Disorders Questions and Answers

Question 1

A 66-year-old male with a significant smoking history presents with increased dyspnea, wheezing, and a change in sputum color from white to green over the past three days.
His baseline oxygen saturation is 91% on 2L nasal cannula, but today it is 87%.
According to the GOLD guidelines, which of the following is the most critical initial intervention for his acute COPD exacerbation?

Accepted Answer

Initiate systemic corticosteroids and inhaled short-acting bronchodilators

Answer

Administer high-flow oxygen to achieve an SpO2 of >95%

Answer

Obtain an urgent CT angiogram of the chest

Answer

Start broad-spectrum intravenous antibiotics immediately

Question 2

A 28-year-old patient reports waking up with coughing and wheezing four nights per month. They use their albuterol inhaler approximately three times per week for symptom relief. Their FEV1 is 85% of predicted. According to the National Asthma Education and Prevention Program (NAEPP) guidelines, what is the most appropriate classification of this patient's asthma severity?

Accepted Answer

Mild persistent

Answer

Moderate persistent

Answer

Intermittent

Answer

Severe persistent

Question 3

A 68-year-old female with diabetes presents with a 3-day history of fever, productive cough, and new-onset confusion. On examination, her respiratory rate is 32 breaths/min, blood pressure is 88/58 mmHg, and her BUN is 25 mg/dL. Which of the following is the most appropriate action based on the CURB-65 score?

Accepted Answer

Admit to the intensive care unit for management of severe pneumonia

Answer

Discharge home with oral antibiotics

Answer

Admit to a general medical ward for inpatient treatment

Answer

Observe in the emergency department for 4-6 hours before making a disposition decision

Question 4

A 55-year-old male presents to the emergency department with an acute onset of pleuritic chest pain and dyspnea. He returned from an international flight yesterday. His heart rate is 115 bpm, and his O2 saturation is 90% on room air. A D-dimer is elevated. According to diagnostic algorithms for suspected pulmonary embolism (PE), what is the most appropriate next step for this hemodynamically stable patient?

Accepted Answer

CT pulmonary angiography (CTPA)

Answer

Chest X-ray

Answer

Lower extremity venous duplex ultrasound

Answer

Ventilation/perfusion (V/Q) scan

Question 5

According to the 2021 United States Preventive Services Task Force (USPSTF) recommendations, which of the following patients is the most appropriate candidate for annual low-dose computed tomography (LDCT) screening for lung cancer?

Accepted Answer

A 65-year-old current smoker with a 25 pack-year history.

Answer

A 70-year-old who quit smoking 20 years ago but had a 30 pack-year history.

Answer

A 45-year-old current smoker with a 25 pack-year history.

Answer

An 82-year-old former smoker with a 40 pack-year history who quit 10 years ago.

Question 6

A 72-year-old male presents with a progressive, multi-year history of exertional dyspnea and a dry, non-productive cough. Physical examination is notable for digital clubbing and fine, bibasilar inspiratory 'Velcro-like' crackles. Pulmonary function tests demonstrate a restrictive pattern. Which of the following is the most likely diagnosis?

Accepted Answer

Idiopathic pulmonary fibrosis (IPF)

Answer

Chronic obstructive pulmonary disease (COPD)

Answer

Congestive heart failure

Answer

Asthma